Individual
MR. PETR N LOKOTKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
161 HIGH ST SE STE 231, SALEM, OR 97301-3620
(503) 400-7126
Mailing address
5945 SAGRADA ST N, KEIZER, OR 97303-3785
(503) 400-7126
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
NO. 062326
OR
Other
Enumeration date
08/17/2011
Last updated
08/17/2011
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